Colorectal Cancer Surgery in Antalya — Hub Guide

Cancer of the colon or rectum arising from the inner lining of the large bowel and rectum.

Possible symptoms include change in bowel habits, blood in stool, unexplained weight loss, anemia and abdominal pain; early stages may be asymptomatic.

Diagnosis is based on history, examination, colonoscopy and biopsy. Staging uses CT, MRI, chest imaging and tumor markers (e.g. CEA).

Planning is multidisciplinary, based on tumor location and stage, the patient's overall health and pathology.

Surgery, chemotherapy and, when needed, radiotherapy are planned together with medical and radiation oncology.

Different resections are used depending on tumor location.

• Right hemicolectomy
• Left hemicolectomy
• Sigmoidectomy
• Anterior resection with total mesorectal excision (TME)
• Abdominoperineal resection when indicated
• Colostomy/ileostomy in emergency settings

This hub covers the following sub-topics; each requires its own clinical assessment and treatment plan.

• Colon cancer (right and left colon)
• Rectal cancer and sphincter-preserving surgery
• Anal canal cancer
• Colorectal cancer screening and early diagnosis
• ERAS (enhanced recovery) protocol
• Colorectal liver metastases
• Recurrent disease
• Stoma care and quality of life
• Palliative surgical approaches

Right colon (cecum, ascending colon) tumors often present with anemia and fatigue; left colon (descending, sigmoid) tumors more often with change in bowel habits or obstruction.

Resection is planned according to tumor location; a laparoscopic approach is preferred in suitable cases.

Local staging with MRI is critical in rectal cancer; neoadjuvant chemoradiotherapy is often planned for distal tumors.

Sphincter-preserving surgery with total mesorectal excision (TME) is the goal in eligible cases; abdominoperineal resection (APR) may be needed for very distal tumors or sphincter invasion.

Squamous cell carcinoma of the anal canal is treated primarily with chemoradiotherapy; surgery has a complementary role in residual or recurrent disease.

Evaluation includes anoscopy, biopsy, pelvic MRI and, when needed, PET-CT.

Screening is generally recommended from age 45–50 in average-risk adults; earlier in those with a family history.

Options include fecal occult blood testing, colonoscopy and, when needed, CT colonography; colonoscopy allows both diagnosis and polyp removal.

In suitable cases, the laparoscopic approach aims for small incisions, less pain, faster bowel recovery and earlier discharge.

Preservation of oncologic principles (adequate lymph node harvest, clear margins) is the priority.

ERAS is a bundle of pre-, intra- and post-operative multidisciplinary measures.

Early mobilisation, early oral intake, opioid-sparing analgesia and standardised bowel-preparation policies can shorten length of stay and reduce complications.

The liver is the most common site of distant metastasis in colorectal cancer; resection of resectable metastases improves survival.

Decision-making is joint with hepatobiliary surgery, medical oncology and interventional radiology; synchronous or metachronous strategies are considered.

Post-operative surveillance includes clinical review, CEA, imaging (CT/MRI) and colonoscopy at defined intervals.

For local or systemic recurrence, options (re-resection, chemotherapy, radiotherapy, interventional procedures) are individualised at the tumor board.

For patients needing a temporary or permanent stoma, education with a stoma nurse is essential; skin care, pouching and nutrition guidance ease the process.

Psychological support and peer communities can be part of the pathway.

Where curative resection is not possible, palliative surgery (stoma, bypass, stenting) may be planned for obstruction, bleeding or perforation.

The aim is to improve patient comfort and quality of life.

Workup includes blood tests, cardiac evaluation, nutritional assessment and, where needed, neoadjuvant chemo/radiotherapy planning.

Follow-up is multidisciplinary and includes clinical review, blood tests, imaging and colonoscopy.

Op.Dr.Gökhan ATEŞ practices in Muratpaşa, Antalya, and welcomes patients from Konyaaltı, Lara, Kepez and from other regions of Türkiye and abroad.